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Question Five: Universal Health Care Policy

Voters in the Barnstable legislative district, including Martha’s Vineyard, have an opportunity to vote in favor of establishing a single payer system for health care for the commonwealth of Massachusetts. Please look for the public policy question on your Nov. 4 ballot regarding health care as a human right and vote yes (Question Five in Aquinnah, Chilmark, Edgartown, Oak Bluffs and West Tisbury, and Question Six in Tisbury).

I first wrote a letter to the editor in favor of single payer plan five years ago. Yes, Massachusetts has made some progress with the Commonwealth Care program in insuring many previously uninsured citizens, primarily those of low income. But costs are increasing as more individuals are enrolled, and our state legislators are facing a significant budget deficit that will no doubt affect the future roll-out of Commonwealth Care, and may cut current benefits. Citizens who are of middle income who do not have employer based insurance and seek to enroll in Commonwealth Care must pay premiums nearly as expensive as private plans. So as a health insurance plan, it is falling short, primarily because it is still based on individuals and employers paying premiums, and many remain uninsured. The only approach to funding health care that will truly provide universal coverage to all citizens is single payer plan.

I am a nurse, and from the perspective of my employment in a primary care office, I can list many reasons why the single payer system makes the most sense for optimal health care. Health care, both preventive care and in times of illness, ought to be the right of every citizen. It should not depend on employment, or whether your employer offers a health care plan. Patients at times self-limit preventive or sick care because of coverage concerns. The health care system should not place unreasonable demands on medical practices seeking to provide the best care possible. I see daily the administrative burden of our current myriad private insurance system on the physicians, nurses, and medical office staff. This burden sometimes delays needed care or medication for patients.

But the most persuasive argument for a single payer plan is economic. Everyone is very worried about the economy right now. Yes, a single payer plan relies on public money, which means taxes one way or another. Taxes are unpopular with just about everybody. But we must realize that whatever all of us, individuals and businesses, will be required to pay in taxes to fund a single payer plan is far less than what we are currently spending on health care. Health insurance premiums are increasing by double digit percentages every year. Employers are asking their employees to shoulder more and more of the premiums, or cutting benefits, or dropping health insurance plans altogether. Retirees are losing health care benefits promised by their employers and are having to seek out expensive private secondary insurance.

And then there are hidden costs. Almost a third of our health insurance premium goes to administrative costs, not health care. Some of our premium pays for those who lack health insurance and seek so-called free care in hospital emergency rooms. In addition, each of us who pays federal and state taxes and owns or rents a home here on Martha’ Vineyard is paying for the health care insurance of every federal, state, county, and town employee. And everything that we buy, from a new car to a box of cereal, includes the cost of health insurance for the workers who made, transported, or sold that product to us.

If we had single payer plan, the health burden would be lifted from employers. Maybe employers would pass their savings on to their employees with better salaries, or their consumers with lower prices, or investment in new products, services, and employees, or their stockholders with higher profits, all of which would only be good for the economy.

All of the state representative candidates are in favor of single payer plan, but credit is due to Dan Larkosh, the Democratic party candidate who is taking a lead to get the word out about this important opportunity in the upcoming election. Please vote yes on Question Five (or Question Six)